Cardinale F, Mangini F, Berardi M, Sterpeta Loffredo M, Chinellato I, Dellino A, Cristofori F, Di Domenico F, Mastrototaro M F, Cappiello A, Centoducati T, Carella F, Armenio L
Clinica Pediatrica 1, Dipartimento di Biomedicina dell'Età Evolutiva, Università di Bari, Bari, Italia.
Minerva Pediatr. 2008 Dec;60(6):1401-9.
Contrary to common believing, the prevalence of the intolerance to food additives in the general population is rather low. Nowadays many doubts persist with regard both to the pathogenetic mechanisms and to the clinical and diagnostic aspects in this field. Symptoms due to, or exacerbated from, food additives usually involve non-IgE-mediate mechanisms (pseudo-allergic reactions, PAR) and are usually less severe of those induced by food allergy. The most frequent clinical feature of the intolerance to food additives still remains the urticaria-angioedema syndrome, although these substances are really involved only in a minority of patients. Other possible clinical features include anaphylaxis, atopic eczema, behaviour disturbances, asthma and non-allergic rhinitis. The diagnostic approach consists in diary cards, reporting symptoms and food habits, elimination diet and double blinded placebo-controlled oral challenge with suspected additives. However, such procedure still remains poorly standardized and numerous uncertainties persist with regard to optimal conditions for performing and interpret the challenge results. The therapeutic approach consists in the exclusion of foods and products containing the additive involved, and, in patients not compliant to the diet, in treatment with symptomatic drugs.
与普遍看法相反，普通人群中对食品添加剂不耐受的发生率相当低。如今，在该领域的发病机制以及临床和诊断方面仍存在许多疑问。由食品添加剂引起或因食品添加剂而加重的症状通常涉及非IgE介导的机制（假性过敏反应，PAR），并且通常比食物过敏引起的症状轻。对食品添加剂不耐受最常见的临床特征仍然是荨麻疹-血管性水肿综合征，尽管这些物质实际上仅涉及少数患者。其他可能的临床特征包括过敏反应、特应性皮炎、行为障碍、哮喘和非过敏性鼻炎。诊断方法包括记录症状和饮食习惯的日记卡、排除饮食以及对可疑添加剂进行双盲安慰剂对照口服激发试验。然而，这种程序仍未得到很好的标准化，在进行和解释激发试验结果的最佳条件方面仍存在许多不确定性。治疗方法包括排除含有相关添加剂的食物和产品，对于不遵守饮食规定的患者，使用对症药物进行治疗。
